Kinugasa-Taniguchi Yukiko, Ueda Yutaka, Hara-Ohyagi Chifumi, Enomoto Takayuki, Kanagawa Takeshi, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
J Reprod Med. 2011 Mar-Apr;56(3-4):142-8.
To compare obstetric and delivery outcomes between myoma-complicated pregnancies and pregnancies that follow myomectomy.
Among the 7,589 deliveries performed in the Department of Obstetrics and Gynecology of the Osaka University Hospital, Osaka, Japan, from 1994 to 2007, women with a past history of myomectomy and those with myoma during their pregnancy were enrolled in this study. Their clinical records were reviewed retrospectively.
The frequency of myomas detected during pregnancy significantly increased by 1.8-fold during the first 7-year period as compared with the latter 7-year period of the study (p < 0.001). The obstetric and delivery outcomes, including the rate of cesarean section, the rate of preterm delivery and the amount of blood loss at delivery, were better in pregnancies complicated with current myoma than those in pregnancies which had undergone previous myomectomy (p < 0.001, p = 0.002 and p = 0.005, respectively), with the exception of an increased need for analgesic medication.
Myomectomy of large asymptomatic myomas does not improve future obstetric and delivery outcomes, indicating that most asymptomatic myomas should be managed conservatively in women still considering childbearing.
比较肌瘤合并妊娠与肌瘤切除术后妊娠的产科及分娩结局。
在1994年至2007年期间于日本大阪大学医院妇产科进行的7589例分娩中，纳入有肌瘤切除术史的女性以及孕期患有肌瘤的女性。对她们的临床记录进行回顾性分析。
与研究的后7年相比，孕期发现肌瘤的频率在前7年显著增加了1.8倍（p < 0.001）。肌瘤合并妊娠的产科及分娩结局，包括剖宫产率、早产率和分娩时失血量，均优于既往接受过肌瘤切除术的妊娠（分别为p < 0.001、p = 0.002和p = 0.005），但镇痛药物的使用需求增加除外。
切除大型无症状肌瘤并不能改善未来的产科及分娩结局，这表明对于仍在考虑生育的女性，大多数无症状肌瘤应采取保守治疗。
